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Annual Meeting of the Canadian Ophthalmological Society
AMERICAN JOURNAL OF OPHTHALMOLOGY Published
Monthly
by the Ophthalmic
Publishing
Company
EDITORIAL STAFF DERRICK VAIL, Editor-in-Chief
JAMES E. LEBENSOHN
4010 West Madison Street, Chicago 24
700 North Michigan Avenue, Chicago 11 LAWRENCE T. POST, Consulting Editor
DONALD J. LYLE
601 Union Trust Building, Cincinnati 2
640 South Kingshighway, Saint Louis 10 BERNARD BECKER
WILLIAM A. MANN
640 South Kingshighway, Saint Louis 10
30 North Michigan Avenue, Chicago 2
WILLIAM L. BENEDICT
P. ROBB MCDONALD
100 First Avenue Building, Rochester, Minnesota FREDERICK C. CORDES
1930 Chestnut Street, Philadelphia 3 JOHN V. V. NICHOLLS
384 Post Street, San Francisco 8
1414 Drummond Street, Montreal
SIR STEWART DUKE-ELDER
ALGERNON B. REESE
63 Harley Street, London, W.l
73 East 71st Street, New York 21
EDWIN B. DUNPHY
243 Charles Street, Boston 14
PHILLIPS THYGESON
220 Meridian Road San Jose 26, California
F. HERBERT HAESSLER
561 North 15th Street, Milwaukee 3
PARKER HEATH
M. URIBE TRONCOSO
243 Charles Street, Boston 14
S00 West End Avenue, New York 24
S. RODMAN IRVINE
ALAN C. WOODS
9730 Wilshire Boulevard, Beverly Hills, California
Johns Hopkins Hospital, Baltimore 5
KATHERINE FERGUSON CHALKLEY, Manuscript Editor
Lake Geneva, Wisconsin Directors: WILLIAM L. BENEDICT, President; FREDERICK C. CORDES, Vice-President; WILLIAM A. MANN, Secretary and Treasurer; F. HERBERT HAESSLER, DERRICK VAIL, ALAN C. WOODS.
Address original papers, other scientific communications including correspondence, also books for review to Dr. Derrick Vail, 700 North Michigan Avenue, Chicago 11, Illinois; Society Proceedings to Mrs. Katherine F. Chalkley, Lake Geneva, Wisconsin. Manuscripts should be original copies, typed in double space, with wide margins. Exchange copies of medical journals should be sent to Dr. F. Herbert Haessler, 561 North 15th Street, Milwaukee 3, Wisconsin. Subscriptions, application for single copies, notices of changes of address, and communications with reference to advertising should be addressed to the Manager of Subscriptions and Advertising, 664 North Michigan Avenue, Chicago 11, Illinois. Copy of advertisements must be sent to the manager by the 15th of the month preceding its appearance. Change of address notice should be received not later than the 15th of the month prior to the issue for which the change is to go into effect. Both old and new addresses should be given. Author's proofs should be corrected and returned within forty-eight hours to the Manuscript Editor, Mrs. Katherine F. Chalkley, Lake Geneva, Wisconsin. Twenty-five reprints of each article will be sup plied to the author without charge. Additional reprints may be obtained from the printer, the George Banta Publishing Company, 450-458 Abnaip Street, Menasha, Wisconsin, if ordered at the time proofs are returned. But reprints to contain colored plates must be ordered when the article is accepted. ANNUAL MEETING O F T H E CANADIAN OPHTHALMOLOGICAL The 16th annual meeting of the Canadian Ophthalmological Society was held at Minaki Lodge, Minaki, Ontario, J u n e 14th to 16th. The attendance was excellent, a n d the pro gram most interesting. D r . E . P . Birch of St. Paul, Minnesota, was the guest speaker and gave a paper on the "Safeguards in cata ract surgery." This was a most compre hensive and carefully thought-out discussion
SOCIETY
of the subject. H e dealt with it under preoperative examination, the pyschologic and physical preparation of the patient, operative and anesthetic technique, a n d postoperative care and refraction. Dr. S. T . Adams and D r . J. R. Bourne of Montreal presented a "Report of 175 cases of glaucoma with special reference to classi fication, gonioscopy, and tonography." They
1146
EDITORIALS divided their cases basically into the openangle and closed-angle groups with subdivi sions of each. In their study there was good correlation between the tonogram and the status of the angle in the closed-angle types. They found that trephining operations nor malize the tonogram. They found consider able difficulty in classifying borderline cases by these means. Dr. R. J. MacDonald and Dr. T. H. Hodgson of Toronto, presented a report of their fundamental investigations on the aque ous flow. Their paper entitled "Slitlamp studies on the flow of the aqueous," de scribed an improved method for accurately measuring changes in the concentration of fluorescein in the anterior chamber without disrupting the physiology of the eye. In these experiments, fluorescein was administered by instillation in the conjunctival sac. By slitlamp readings the concentration in the aqueous was read at intervals and thus the aqueous flow could be determined. They found that fluctuations in the bulk rate of flow, either spontaneous or following the installation of a myotic, were reflected in the changes in flow in the aqueous veins, but neither the fluctuations nor the aqueous-vein changes bore a constant parallel relationship to tonometry readings. Case reports were presented on, "Sym pathetic ophthalmia" by Dr. W. C. Guest of Winnipeg, on "Toxoplasmosis," by Dr. E. N. Wright of Port Arthur and by Dr. J. E. Rose of Winnipeg on "The entry of an oily ointment into the anterior chamber following a traumatic wound of the cornea." In a paper on the "Histologic interpreta tion of fundus lesions," Dr. O. B. Richard son of Toronto showed several Kodachrome slides depicting the fundus picture and his tologic changes in certain vascular lesions of the fundus. Dr. J. C. Locke of Montreal presented a paper on "Retrolental fibroplasia," showing in its production the definitive role of oxygen administration to the premature infant. His very careful studies presented strong evi
1147
dence that the administration of a super abundance of oxygen increases the incidence of this disease. Dr. W. W. Wright reported on "The work of the C.N.I.B. for the blind and for the prevention of blindness." A most inter esting genetic study of "Myotonia atrophia" and its ocular features was presented by Dr. J. Maciver of Owen Sound. Dr. B. Alexander of Montreal presented a complete case history with pathologic slides of an exceedingly rare condition, "Astrocytoma of the retina." Dr. J. A. MacLean of Vancouver reported on the results obtained in 17 cases in which the Ridley acrylic lens was used at the time of cataract extraction. He emphasized the importance of keeping the pupil mobile after operation and properly selecting the patients. Dr. E. Powell of Port Arthur discussed the "Treatment of congenital ptosis," and presented his results obtained in treating several patients with this disturbance. In those cases in which there is no levator action he prefers the fascia-lata sling operation of Wright. Dr. J. V. V. Nicholls of Montreal pre sented a clinical study of seven cases in six patients of "Macular edema in association with cataract extraction." The clinical find ings indicated that the basic cause was a vascular dysfunction of an arteriosclerotic or an arteriospastic nature, and that the precipi tating cause was anxiety in some cases and prolapse of the vitreous forward through the pupil in others. Dr. J. H. Quigley and Dr. J. F. Ballantyne of Toronto presented the results of a study on the "Antibiotic sensitivities of strains of Staphylococcus aureus recovered from eye cultures." They found in 146 cases of coagulase-producing Staphylococcus aureus that 32.9 percent were sensitive to penicillin, 69.2 percent to aureomycin, 71.2 percent to streptomycin, and 82.2 percent to chloramphenicol. Apparently resistant strains were more common among hospital patients. Dr. C. H. Andrews of Prince Albert,
1148
EDITORIALS
showed the importance of proper centering of lenses, centration being determined by the power of the lenses, and in readers by the reserved power of convergence. John V. V. Nicholls.
GOLDEN JUBILEE OF T H E EGYPTIAN OPHTHALMOLOGICAL SOCIETY The Golden Jubilee meeting of the Egyp tian Ophthalmological Society was held in Cairo, February 15th to 28th, under the chairmanship of the president of the society, Dr. Mohamed Tewfik. It was attended by visitors, several hundred in all, from all over the world, but particularly from the Arab countries of the Middle East. The World Health Organization contributed to the meet ing by sending a group of six ophthalmolo gists from Europe and the United States to participate in the proceedings and to conduct a co-operative seminar for the 10 days im mediately following the congress. The con gress met in the offices of the Egyptian Medical Association and the seminar was held at the Kasr-el-Aini Hospital and the Giza Memorial Ophthalmic Laboratory. The meeting was opened formally with an address of welcome by His Excellency Nureddin Tarraf, Minister of Health. This was followed by addresses by Dr. A. T. Shousha, regional director of the World Health Or ganization, and Dr. Mohamed Tewfik, the president of the society. Dr. Tewfik's ad dress concerned the founding of the society and its important role during the past 50 years in the dissemination of ophthalmologic knowledge and the improvement in oph thalmologic care. These talks were followed in turn by the Suleiman Lecture of the Ophthalmological Society of Egypt which was given by Prof. Karl Lindner of Vienna, chairman of the World Health Organization group. Dr. Lindner's subject was "Improve ment or cure of myopia by one or two stage
scleral resection." The annual Suleiman Lec ture was founded in 1940 in memory of the late Prof. Sayel Abd El Hamid Suleiman Pasha. The program of the congress proper con sisted in five communications by other mem bers of the World Health Organization group, and in 48 short communications, many of them of unusual interest and importance. Signal among these were the following: A report of three cases of gumma of the orbit by Prof. M. A. H. Attiah; a report on epidemics of virogenic acute keratoconjunctivities with membrane formation and herpetiform vesicular eruptions by Dr. I. A. Mohamed and Dr. G. Badir; a contribution to the histopathogenesis of trachoma by Dr. G. Badir; papers on trachoma control by Dr. F. Maxwell Lyons, and on the triple symp tom complex of Behc.et by Dr. M. Bishay; a report of two cases of Vogt-Koyanagi syn drome by Prof. A. M. Soliman; notes on the surgical control of glaucoma secondary to essential atrophy of the iris by Dr. Sabri Kamel, and on experience with cyclodiathermy for glaucoma by Prof. M. A. H. Attiah and Dr. Aly Mortada; the first report of an Egyptian case of retrolental fibroplasia by Prof. A. M. Soliman and Dr. M. ElArabi; and reports on Echinococcus cyst of the eyeball by Dr. Olga Litricin of Yugo slavia, and on Ascarides in ophthalmology by Dr. Dusan Dobrovic, also of Yugoslavia. In addition to the reports, a number of films were shown; these dealt with surgical sub jects and were of both European and Ameri can origin. In view of the outstanding importance of the ophthalmias in Egypt, it was to be ex pected that keratoconjunctivitis would be the subject of many papers. There seemed to be general agreement that the acute ophthalmias complicating trachoma were being satisfac torily handled by the sulfonamides or anti biotics but that the incidence of trachoma itself had not yet been markedly reduced. There seemed to be considerable hope, how-
Monthly
by the Ophthalmic
Publishing
Company
EDITORIAL STAFF DERRICK VAIL, Editor-in-Chief
JAMES E. LEBENSOHN
4010 West Madison Street, Chicago 24
700 North Michigan Avenue, Chicago 11 LAWRENCE T. POST, Consulting Editor
DONALD J. LYLE
601 Union Trust Building, Cincinnati 2
640 South Kingshighway, Saint Louis 10 BERNARD BECKER
WILLIAM A. MANN
640 South Kingshighway, Saint Louis 10
30 North Michigan Avenue, Chicago 2
WILLIAM L. BENEDICT
P. ROBB MCDONALD
100 First Avenue Building, Rochester, Minnesota FREDERICK C. CORDES
1930 Chestnut Street, Philadelphia 3 JOHN V. V. NICHOLLS
384 Post Street, San Francisco 8
1414 Drummond Street, Montreal
SIR STEWART DUKE-ELDER
ALGERNON B. REESE
63 Harley Street, London, W.l
73 East 71st Street, New York 21
EDWIN B. DUNPHY
243 Charles Street, Boston 14
PHILLIPS THYGESON
220 Meridian Road San Jose 26, California
F. HERBERT HAESSLER
561 North 15th Street, Milwaukee 3
PARKER HEATH
M. URIBE TRONCOSO
243 Charles Street, Boston 14
S00 West End Avenue, New York 24
S. RODMAN IRVINE
ALAN C. WOODS
9730 Wilshire Boulevard, Beverly Hills, California
Johns Hopkins Hospital, Baltimore 5
KATHERINE FERGUSON CHALKLEY, Manuscript Editor
Lake Geneva, Wisconsin Directors: WILLIAM L. BENEDICT, President; FREDERICK C. CORDES, Vice-President; WILLIAM A. MANN, Secretary and Treasurer; F. HERBERT HAESSLER, DERRICK VAIL, ALAN C. WOODS.
Address original papers, other scientific communications including correspondence, also books for review to Dr. Derrick Vail, 700 North Michigan Avenue, Chicago 11, Illinois; Society Proceedings to Mrs. Katherine F. Chalkley, Lake Geneva, Wisconsin. Manuscripts should be original copies, typed in double space, with wide margins. Exchange copies of medical journals should be sent to Dr. F. Herbert Haessler, 561 North 15th Street, Milwaukee 3, Wisconsin. Subscriptions, application for single copies, notices of changes of address, and communications with reference to advertising should be addressed to the Manager of Subscriptions and Advertising, 664 North Michigan Avenue, Chicago 11, Illinois. Copy of advertisements must be sent to the manager by the 15th of the month preceding its appearance. Change of address notice should be received not later than the 15th of the month prior to the issue for which the change is to go into effect. Both old and new addresses should be given. Author's proofs should be corrected and returned within forty-eight hours to the Manuscript Editor, Mrs. Katherine F. Chalkley, Lake Geneva, Wisconsin. Twenty-five reprints of each article will be sup plied to the author without charge. Additional reprints may be obtained from the printer, the George Banta Publishing Company, 450-458 Abnaip Street, Menasha, Wisconsin, if ordered at the time proofs are returned. But reprints to contain colored plates must be ordered when the article is accepted. ANNUAL MEETING O F T H E CANADIAN OPHTHALMOLOGICAL The 16th annual meeting of the Canadian Ophthalmological Society was held at Minaki Lodge, Minaki, Ontario, J u n e 14th to 16th. The attendance was excellent, a n d the pro gram most interesting. D r . E . P . Birch of St. Paul, Minnesota, was the guest speaker and gave a paper on the "Safeguards in cata ract surgery." This was a most compre hensive and carefully thought-out discussion
SOCIETY
of the subject. H e dealt with it under preoperative examination, the pyschologic and physical preparation of the patient, operative and anesthetic technique, a n d postoperative care and refraction. Dr. S. T . Adams and D r . J. R. Bourne of Montreal presented a "Report of 175 cases of glaucoma with special reference to classi fication, gonioscopy, and tonography." They
1146
EDITORIALS divided their cases basically into the openangle and closed-angle groups with subdivi sions of each. In their study there was good correlation between the tonogram and the status of the angle in the closed-angle types. They found that trephining operations nor malize the tonogram. They found consider able difficulty in classifying borderline cases by these means. Dr. R. J. MacDonald and Dr. T. H. Hodgson of Toronto, presented a report of their fundamental investigations on the aque ous flow. Their paper entitled "Slitlamp studies on the flow of the aqueous," de scribed an improved method for accurately measuring changes in the concentration of fluorescein in the anterior chamber without disrupting the physiology of the eye. In these experiments, fluorescein was administered by instillation in the conjunctival sac. By slitlamp readings the concentration in the aqueous was read at intervals and thus the aqueous flow could be determined. They found that fluctuations in the bulk rate of flow, either spontaneous or following the installation of a myotic, were reflected in the changes in flow in the aqueous veins, but neither the fluctuations nor the aqueous-vein changes bore a constant parallel relationship to tonometry readings. Case reports were presented on, "Sym pathetic ophthalmia" by Dr. W. C. Guest of Winnipeg, on "Toxoplasmosis," by Dr. E. N. Wright of Port Arthur and by Dr. J. E. Rose of Winnipeg on "The entry of an oily ointment into the anterior chamber following a traumatic wound of the cornea." In a paper on the "Histologic interpreta tion of fundus lesions," Dr. O. B. Richard son of Toronto showed several Kodachrome slides depicting the fundus picture and his tologic changes in certain vascular lesions of the fundus. Dr. J. C. Locke of Montreal presented a paper on "Retrolental fibroplasia," showing in its production the definitive role of oxygen administration to the premature infant. His very careful studies presented strong evi
1147
dence that the administration of a super abundance of oxygen increases the incidence of this disease. Dr. W. W. Wright reported on "The work of the C.N.I.B. for the blind and for the prevention of blindness." A most inter esting genetic study of "Myotonia atrophia" and its ocular features was presented by Dr. J. Maciver of Owen Sound. Dr. B. Alexander of Montreal presented a complete case history with pathologic slides of an exceedingly rare condition, "Astrocytoma of the retina." Dr. J. A. MacLean of Vancouver reported on the results obtained in 17 cases in which the Ridley acrylic lens was used at the time of cataract extraction. He emphasized the importance of keeping the pupil mobile after operation and properly selecting the patients. Dr. E. Powell of Port Arthur discussed the "Treatment of congenital ptosis," and presented his results obtained in treating several patients with this disturbance. In those cases in which there is no levator action he prefers the fascia-lata sling operation of Wright. Dr. J. V. V. Nicholls of Montreal pre sented a clinical study of seven cases in six patients of "Macular edema in association with cataract extraction." The clinical find ings indicated that the basic cause was a vascular dysfunction of an arteriosclerotic or an arteriospastic nature, and that the precipi tating cause was anxiety in some cases and prolapse of the vitreous forward through the pupil in others. Dr. J. H. Quigley and Dr. J. F. Ballantyne of Toronto presented the results of a study on the "Antibiotic sensitivities of strains of Staphylococcus aureus recovered from eye cultures." They found in 146 cases of coagulase-producing Staphylococcus aureus that 32.9 percent were sensitive to penicillin, 69.2 percent to aureomycin, 71.2 percent to streptomycin, and 82.2 percent to chloramphenicol. Apparently resistant strains were more common among hospital patients. Dr. C. H. Andrews of Prince Albert,
1148
EDITORIALS
showed the importance of proper centering of lenses, centration being determined by the power of the lenses, and in readers by the reserved power of convergence. John V. V. Nicholls.
GOLDEN JUBILEE OF T H E EGYPTIAN OPHTHALMOLOGICAL SOCIETY The Golden Jubilee meeting of the Egyp tian Ophthalmological Society was held in Cairo, February 15th to 28th, under the chairmanship of the president of the society, Dr. Mohamed Tewfik. It was attended by visitors, several hundred in all, from all over the world, but particularly from the Arab countries of the Middle East. The World Health Organization contributed to the meet ing by sending a group of six ophthalmolo gists from Europe and the United States to participate in the proceedings and to conduct a co-operative seminar for the 10 days im mediately following the congress. The con gress met in the offices of the Egyptian Medical Association and the seminar was held at the Kasr-el-Aini Hospital and the Giza Memorial Ophthalmic Laboratory. The meeting was opened formally with an address of welcome by His Excellency Nureddin Tarraf, Minister of Health. This was followed by addresses by Dr. A. T. Shousha, regional director of the World Health Or ganization, and Dr. Mohamed Tewfik, the president of the society. Dr. Tewfik's ad dress concerned the founding of the society and its important role during the past 50 years in the dissemination of ophthalmologic knowledge and the improvement in oph thalmologic care. These talks were followed in turn by the Suleiman Lecture of the Ophthalmological Society of Egypt which was given by Prof. Karl Lindner of Vienna, chairman of the World Health Organization group. Dr. Lindner's subject was "Improve ment or cure of myopia by one or two stage
scleral resection." The annual Suleiman Lec ture was founded in 1940 in memory of the late Prof. Sayel Abd El Hamid Suleiman Pasha. The program of the congress proper con sisted in five communications by other mem bers of the World Health Organization group, and in 48 short communications, many of them of unusual interest and importance. Signal among these were the following: A report of three cases of gumma of the orbit by Prof. M. A. H. Attiah; a report on epidemics of virogenic acute keratoconjunctivities with membrane formation and herpetiform vesicular eruptions by Dr. I. A. Mohamed and Dr. G. Badir; a contribution to the histopathogenesis of trachoma by Dr. G. Badir; papers on trachoma control by Dr. F. Maxwell Lyons, and on the triple symp tom complex of Behc.et by Dr. M. Bishay; a report of two cases of Vogt-Koyanagi syn drome by Prof. A. M. Soliman; notes on the surgical control of glaucoma secondary to essential atrophy of the iris by Dr. Sabri Kamel, and on experience with cyclodiathermy for glaucoma by Prof. M. A. H. Attiah and Dr. Aly Mortada; the first report of an Egyptian case of retrolental fibroplasia by Prof. A. M. Soliman and Dr. M. ElArabi; and reports on Echinococcus cyst of the eyeball by Dr. Olga Litricin of Yugo slavia, and on Ascarides in ophthalmology by Dr. Dusan Dobrovic, also of Yugoslavia. In addition to the reports, a number of films were shown; these dealt with surgical sub jects and were of both European and Ameri can origin. In view of the outstanding importance of the ophthalmias in Egypt, it was to be ex pected that keratoconjunctivitis would be the subject of many papers. There seemed to be general agreement that the acute ophthalmias complicating trachoma were being satisfac torily handled by the sulfonamides or anti biotics but that the incidence of trachoma itself had not yet been markedly reduced. There seemed to be considerable hope, how-